Breast Cancer Targeted Therapy
Trastuzumab (Herceptin) is a humanized monoclonal antibody that specifically targets the extracellular region of human epidermal growth factor receptor 2 (HER-2). Five clinical trials of trastuzumab as adjuvant treatment for breast cancer have been published, and adjuvant trastuzumab treatment for HER-2-positive breast cancer patients can significantly improve disease-free survival. Yan Min, Department of Breast Medicine, Henan Cancer Hospital
Based on the data from the clinical study, the NCCN guidelines recommend that
adjuvant trastuzumab should be given for 1 year in postoperative HER-2-positive breast cancer patients with primary tumor >1 cm or positive axillary lymph nodes.
Trastuzumab may also be considered in patients with 0.6 to 1 cm primary tumor, intermediate/low differentiation, or lymph node negativity with poor prognostic factors (choroidal carcinoma embolism, high nuclear grade, high histologic grade).
For patients with HER-2-positive metastatic or recurrent breast cancer, a combination regimen of trastuzumab and certain chemotherapies in first line or a single agent regimen is recommended.
The panel also recommends that HER-2-positive patients who experience disease progression after first-line trastuzumab-containing regimens should continue blocking the HER-2 pathway, and this recommendation also applies to HER-2-positive patients who have received prior adjuvant trastuzumab-containing therapy but are newly diagnosed with metastatic breast cancer.